Pediatric Rheumatology Unit, Hospital Universitario La Paz, Madrid, Spain.
Pediatric Rheumatology Unit, UGC Pediatría, Hospital Materno-Infantil de Málaga, Málaga, Spain.
Acta Paediatr. 2018 Oct;107(10):1792-1797. doi: 10.1111/apa.14373. Epub 2018 May 21.
The traditional approach for acute paediatric osteoarticular infections (OAI) has comprised initial intravenous antibiotics followed by prompt oral antibiotics. We assessed how providing just oral antibiotics compared to the traditional two-step approach.
This prospective study was performed at the Hospital La Paz, Madrid, Spain, from September 2015 to September 2016. We compared 25 outpatients, with good general health and a mean age of 25 months who received just oral antibiotics, with 228 hospitalised children of a similar age who received intravenous and oral antibiotics from other hospitals in the Spanish Network of Osteoarticular Infections.
The groups were comparable in terms of age, sex, fever, erythrocyte sedimentation rate value, C-reactive protein and diagnosis. The oral group comprised 15 with osteomyelitis, seven with septic arthritis, two with osteoarthritis and one with spondylodiscitis. This group had a lower percentage of Staphylococcus aureus (8% vs 26%, p = 0.06) and higher proportion of Kingella kingae (24% vs 9%, p = 0.017) than the intravenous group. There were complications (24%) and follow-up sequelae (6%) in the intravenous group, but none in the oral group.
Outpatients with OAI who were in good general health had favourable outcomes when they received oral antibiotics without intravenous antibiotics.
急性儿科骨关节炎感染（OAI）的传统治疗方法包括初始静脉内抗生素治疗，然后迅速转为口服抗生素。我们评估了仅给予口服抗生素与传统两步法相比的效果。
这项前瞻性研究于 2015 年 9 月至 2016 年 9 月在西班牙马德里的拉·帕兹医院进行。我们比较了 25 名一般健康状况良好且平均年龄为 25 个月的门诊患者，他们仅接受口服抗生素治疗，以及来自西班牙骨关节炎感染网络中其他医院的 228 名年龄相似的住院患儿，他们接受静脉内和口服抗生素治疗。
两组在年龄、性别、发热、红细胞沉降率值、C 反应蛋白和诊断方面具有可比性。口服组包括 15 例骨髓炎、7 例化脓性关节炎、2 例骨关节炎和 1 例脊椎骨髓炎。该组金黄色葡萄球菌（8%对 26%，p=0.06）比例较低，金氏金菌（24%对 9%，p=0.017）比例较高。静脉组有并发症（24%）和随访后遗症（6%），但口服组没有。
一般健康状况良好的 OAI 门诊患者在接受口服抗生素而不接受静脉抗生素治疗时，结果良好。
